Treating

Scoliosis

Scoliosis is a condition in which there are abnormal side-to-side curves in the spine. This information may assist you in identifying and treating scoliosis in your practice.

What is Scoliosis?

Scoliosis is a condition in which the spine curves sideways in a C or S shape. Some curvature in the spine is normal — even necessary. Spinal curves help us maintain healthy alignment and balance in our back, shoulders, and pelvis. However, when abnormal or exaggerated spinal curves develop, it is called scoliosis.

Scoliosis is somewhat rare, affecting only:

of women in the general population¹.

of men in the

general population¹.

Many conditions can cause or be associated with scoliosis, including cerebral palsy, spina bifida, muscular dystrophy, spinal muscular atrophy, and tumours. However, over 80% of cases are idiopathic — meaning there is no known cause — and are often diagnosed in otherwise healthy people¹.

There are four main types of scoliosis:

Idiopathic Scoliosis
Congenital Scoliosis
Neuromuscular Scoliosis
Early Onset

Idiopathic Scoliosis

means there is no known cause

to explain why the spine develops

a curve. It is the most common

type of scoliosis,

representing 80% of cases¹.

Congenital Scoliosis

(present at birth)

is caused by malformation of the

spine during prenatal development.

The spinal column develops during

the third to sixth week in utero at

the same time as several other

major organ systems.

NMS

Neuromuscular scoliosis occurs in

children with a neuromuscular

disorder that impairs their ability

to control the muscles that support

their spine. Conditions associated

with NMS include cerebral palsy,

spina bifida, muscular

dystrophies, and

spinal cord injuries.

Early onset

Early onset scoliosis (EOS)

is diagnosed in patients younger

than 10 years old¹.

Some EOS cases are

idiopathic, which

is called idiopathic

early onset scoliosis.

Learn more about the types of scoliosis (opens new window)

Diagnosing Scoliosis

Screenings and early warning signs can help detect scoliosis. A specialist will confirm the diagnosis with imaging.

Physical symptoms

There are several different "warning signs" to look for that may indicate a person has scoliosis.

Shoulders are different heights (one shoulder blade is more prominent than the other)
Head is not centered above the pelvis
Appearance of a raised, prominent hip
Rib cages are at different heights
Uneven waist
Changes in look or texture of skin overlying the spine (dimples, hairy patches, colour changes)
Leaning of entire body to one side

If a person has any one or more of these signs, they should should schedule an exam with their doctor.

Nurse measures a patient's spinal curve while performing the Adam's Bend Forward Test.

Scoliosis screening exam

The standard screening exam is the Adam’s Forward Bend Test. In this test, the patient leans forward at the waist 90 degrees with his or her feet together. From this angle, the examiner can easily identify any asymmetry of the back or any abnormal spinal curvatures.

The Adam’s Forward Bend test is popular because it can be administered by doctors or at school by nurses or parent volunteers. It should be noted, however, that this screening test can detect potential curves but cannot determine the precise degree of the curve.

If the screening exam detects a possible spinal curvature, a clinician will confirm a scoliosis diagnosis with an x-ray, CT scan, MRI, or bone scan. Scoliosis curves are measured in degrees:

Minor scoliosis: curve less than 25 degrees, treated through observation²
Moderate scoliosis: curve between 25 and 40 degrees, often treated with bracing²
Severe scoliosis: curve greater than 40 degrees, may require surgical correction²

A male clinician reviews an x-ray that shows a patient's a scoliosis curve.

Treatment options

Depending on the severity of a person's scoliosis, a doctor may recommend observation, bracing, or surgery.

Observation

If the spinal curve is mild (less than 25 degrees) and has low risk for progression, scoliosis may not require active treatment. The doctor will monitor the curve through regular check-ups to watch for progression.

Observation is also an appropriate treatment if a child is diagnosed with moderate scoliosis (25-to 40-degree curve) and has finished growing (typically age 17 for boys and age 15 for girls). At this point, a moderate curve is considered unlikely to progress or cause problems in adulthood². Doctors often recommend follow-up x-rays every five years to confirm that the curve stays stable.

Bracing

Bracing is an option for patients with mild to moderate spinal curves who are still growing. A back brace is a device customised to conform to a patient's body that keeps the spine in a straight, secure position. The goal of bracing is to keep the curve from progressing. Wearing a brace won’t correct the curve, but it may prevent the curve from getting worse as a person grows. Typically, a brace will be worn until a doctor has determined that a patient has finished growing.

Learn more about bracing (opens new window)

Corrective Surgery

Severe scoliosis curves greater than 40 degrees may require corrective surgery. Spinal fusion realigns the curved vertebrae and fuses them together.

The two primary aims of scoliosis surgery are:

To stop a curve from progressing
To reduce rib prominence and to diminish spinal deformity

A surgeon may use one of two primary approaches: the posterior approach or the anterior approach. In some cases, a surgeon may use a combination of the two.

Anterior approach

The anterior approach means a surgeon will access the spinal column from the side of the chest wall, rather than through the back. Certain types of scoliosis curves are especially amenable to the anterior approach².

Learn more about anterior approach (opens new window)

Posterior approach

In a posterior approach operation, a surgeon accesses the spine through the patient’s back. The posterior approach is the most traditional approach to spinal surgery. Most scoliosis surgeries are performed this way².

Learn more about posterior approach (opens new window)

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Medtronic provides this listing as a service. We have no vested interest in any specific physicians, nor do we provide any recommendation, assurance, or guarantee with respect to their service. This listing may not be a complete list of all physicians who provide this service. Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

1 Fadzan, M; Bettany-Saltikov, J. Etiological theories of adolescent idiopathic scoliosis: past and present. 2017. Open Ortho journal. 11 pg 1466-1489

2 Wiggins G.C. et al. Pediatric spinal deformities. 2003. Neurosurg Focus 14 (1) Article 3.